Cerebral Palsy
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AFO’s

LynseynicLynseynic Member Posts: 3 Listener
Hi everyone, I have just joined this website as I saw a discussion on AFO’s. My 2 year old daughter has hemiplegia on her right side and has a splint on her right leg. She has had a splint on her right leg for 5-6 months now and I would like to chat to someone who also has experience wearing a splint. When the splint is on she is fantastic at walking, nearly runs, however when it is off she cannot walk at all. Does anyone know if this will improve with time and the more she wears her splint? 

Many thanks 

Replies

  • StayceStayce Member Posts: 395 Pioneering
    edited October 2017
    Hi @Lynseynic

    The key for your daughter will be a combination of using splints and Physio exercises to do without the splint on to build muscle strength 

    It depends what sort of AFO your daughter has - is it rigid plastic? How far up her leg does it go? In calf height and above rigid  plastic AFOs the foot and ankle are effectively locked in position which is obviously helping your daughter to walk, but the splint won't be helping to build your daughter's leg/foot strength - the splint will be doing all the work for her.

    The more your daughter wears the splint the more aligned her foot/leg will be in a neutral position, which is good. But I would advise you talk to her Physio about exercises you can do with her when she is not wearing the AFO  to strengthen key muscle groups that are not activated through splint use (i.e. these muscle become reliant on the splint to do the job for them so don't fire)

    Hope that helps

    Best



  • Blue FrogBlue Frog Member Posts: 373 Pioneering
    My little girl is 4, she got her AFO's when she had just turned 3. It's slightly different as she doesn't walk - but they have made a huge difference to her standing (in a frame) and she can (sort of) stand better without them too. 

    As @Stayce says, it seems to be the combination of AFO's and physio - but things do seem to improve with time (and hard work) I guess it varies for every child and condition, but it sounds as if you are doing all you can x
  • LynseynicLynseynic Member Posts: 3 Listener
    Thank you @Stacey and @Blue Frog. My lg’s AFO is solid and goes up her calf to below her knee joint. I was unaware the splint would not help her build muscle, I thought by walking she would build muscle. Our physio is pretty useless tbh and hasn’t given us any exercises to do, only a few stretches. Can you suggest any exercises to help build muscle without her splint because she struggles to stand without the splint. We try to get her to do squats while we support her so exercises like that do you think? Thank you 
  • StayceStayce Member Posts: 395 Pioneering
    edited October 2017
    Hi @Lynseynic
    With Hemiplegia (and other forms of CP) muscles don't build in quite the same way as it would for someone else, that why you will see limbs on the affected side are smaller. This is why it is important to establish through Physio to build muscle memory.

    Do you know if the Physio your daughter is seeing is a neurological physio or are they a muscular skeletal? It maybe worth seeking a referral for an neurological Physio for a  more comprehensive exercise programme

    I found the Bobath Centre a great help when I was a child. They do take NHS referrals but it is very much a postcode lottery as to whether you get funding. (as an adult with Hemiplegia I have been unsuccessful twice more recently)

    http://www.bobath.org.uk/

    In terms of exercises;
    The supported squat is a good one. Is it possible to get her to squat with your support while she holds on the back of a child's chair? (that would be another way and gradually reduce your guidance

    You could also try getting her to slide down a wall into the squat - that way your daughter would have the wall for support behind her and you in front.

    Any toys that she could hold on to and wheel in a standing position are considered good 
    as your daughter will get the rhythm of movement with that

    The charity Hemihelp has a DVD my moves which would be worth looking into as it offers an exercise programme specifically for children with Hemiplegia,
    but obviously not a  complete substitute for time with Physio
    http://www.hemihelp.org.uk/support_us/shop/my_moves_exercises_children_hemiplegia

    Any children's games that you could get your daugher to distribute more weight through her affected side would help too


    If you have any further questions just let me know

    Best
  • LynseynicLynseynic Member Posts: 3 Listener
    @Stayce Thank you so much for all you help and advice, it is very useful. I have emailed Bobath to see if they have any workshops in my area and I will also get in touch with Hemihelp about the DVD. You have been much more informative than any doctor or physio we have seen, I really appreciate it x
  • StayceStayce Member Posts: 395 Pioneering
    Hi @Lynseynic
    You are welcome -Glad I could be of help. 

    The Bobath Centre used to hold a voluntary register of Bobath trained physiotherapist so it might be worth asking them about that to see if they know of any in your area. 

    I thought of a couple of other things that are easy to implement that might help your daughter

    1. When she takes a bath- spend some extra time toweling her affected sole of her foot. As you will probably know with Hemiplegia the affected side has reduced sensation (things feel different on the affected side). So this will help with that increasing your daughter's awareness of her affected foot so that she  tries to use it.

    2. Most people with Hemiplegia will have tight hips. So it's worth stretching these out. A good way to do this is with a foam roller (you can buy these on Amazon or T-K Max) - You can basically lay your daughter on this and roll her - it will loosen her hips up which will help with walking.


    I hope this helps. Please let me know how you get on with the Hemihelp DVD and Bobath Centre and how your daughter is getting on. If you have any more questions just message me

    Best



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